摘要
目的探讨食管平滑肌瘤(esophageal leiomyoma,EL)在钡餐造影、CT及MRI检查中的影像学特点。方法回顾36例经手术及病理证实的EL患者术前影像资料(36例均行胸部CT检查,其中17例行食管钡餐造影检查、2例行MRI检查),查找病灶,记录并分析病灶大小、形态、黏膜情况及密度、信号、瘤-空气界面等特征,并与胃镜及手术结果对照。结果钡餐造影表现为新月形或分叶状充盈缺损,病变区黏膜皱襞拉宽、展平,无龛影及黏膜破坏。CT扫描对轴位最大短径大于0.7 cm病灶的敏感性明显高于轴位最大短径小于0.7 cm的病灶,CT检出病灶表现为密度均匀、强化幅度低的结节或肿块,具有食管壁局限性受累、瘤-空气界面光滑、大肿块相应管腔多角状扩张等特点。MRI扫描病灶信号均匀,增强扫描轻度渐进性强化,对食管黏膜及食管周围脂肪可以较好地显示。结论钡餐造影检查对EL的敏感性高,但对病灶实际大小判断不如CT及MRI,且无法了解周围比邻关系;EL的CT及MRI强化具有一定的特征性,CT对小病灶的敏感性不如X线钡餐检查,MRI对食管黏膜及食管周围脂肪的显示优于CT,但MRI样本量尚需更多病例的积累。
Objective To investigate the imaging features of esophageal leiomyoma（EL） in barium meal,CT and MRI examination.Methods A retrospective analysis was made by collecting preoperative imaging data of 36 patients with leiomyoma of the esophagus confirmed by surgery and pathology,among which all the 36 patients underwent chest CT examination,17 patients received esophagus barium meal examination,and 2 patients accepted MRI examination.After the identification of the location of lesions,the size,morphology,mucosal condition,density,signal and tumorair interface were recorded and analyzed,which were then compared with the results of gastroscopy and operation.Results Barium meal examination showed crescent-shaped or lobulated filling defect,mucosal folds were widened and flattened in the lesion area,without niche and mucosa damages.In terms of CT examination,the sensitivity of CT scan to axial maximum diameter of greater than 0.7 cm were significantly higher than those with axial maximum diameter of less than 0.7 cm.Besides,lesions detected by CT presented with homogeneous density and low enhancement nodules or masses,which had the characteristics of localized esophageal wall involvement,smooth tumor-air interface,polygonal dilatation in the corresponding lumen of large tumors.Furthermore,the signal of MRI scan was homogeneous,and mild progressive enhancement was found in the enhanced scan.The esophageal mucosa and fat surrounding the esophagus could be better displayed.Conclusion Barium meal examination has a high sensitivity to EL,but the measurement of actual size of the lesion is not as good as CT and MRI,and the relation with the surrounding structures can not be identified.The enhancement of CT and MRI has certain characteristics in EL,however,the sensitivity of CT to small lesions is less than X-ray barium meal examination.MRI is superior to CT in demonstration of esophageal mucosa and fat surrounding the esophagus,Nevertheless,more samples are required in future studies due to the small sample size in the study.
出处
《转化医学杂志》
2017年第4期225-228,共4页
Translational Medicine Journal
基金
解放军总医院医疗大数据研发项目(2016MBD-021)
关键词
食管平滑肌瘤
钡餐造影
计算机体层摄影术
磁共振成像
Esophageal leiomyoma（EL）
Barium meal
Computed tomograthy（CT）
Magnetic resonance imaging（MRI）
作者简介
[通讯作者]赵绍宏,E-mail：zhaoshaohoiig@aliyun.com
